Kellenberger M, von Arx T, Hardt N
Klinik für Mund-Kiefer-Gesichts-Chirurgie, Kantonsspital Luzern.
Schweiz Monatsschr Zahnmed. 1994;104(12):1482-8.
Disturbances of facial growth, occlusion and temporomandibular joint function respectively are all possible sequelae of condylar fractures in children. In this study 30 children (age at accident from 9 months to 14 years, mean 6 years and 9 months) were reexamined who had sustained conservatively treated condylar fractures. Dysfunction and disturbances within the stomathognathic system were assessed by a clinical and radiographic examination. The mean interval between the accident and the follow-up study was 4 years and 11 months. The maximal interincisive distance was always better than 35 mm. The "en face" analysis revealed 6 cases with an inclined occlusion plane referring to the horizontal plane. Only 3 patients, all with bilateral condylar fractures, showed a restricted mandibular mobility. Remodelling of the condylar head was very good in 77% of the cases. In the frontal plane, 21% of the unilateral cases and 33% of the bilateral cases respectively had a persistent medial inclination of the condyle. The measured difference in length of the processus articularis showed the highest correlation to the previous condylar fracture. The radiological evaluation after Ricketts (1960) and Mulick (1965) to assess facial asymmetry revealed six cases (20%) with a relevant angle difference of more than 5 degrees.
面部生长紊乱、咬合紊乱以及颞下颌关节功能紊乱分别都是儿童髁突骨折可能出现的后遗症。在本研究中，对30名接受保守治疗的髁突骨折儿童（事故发生时年龄从9个月至14岁，平均6岁9个月）进行了复查。通过临床和影像学检查评估口颌系统内的功能障碍和紊乱情况。事故与随访研究之间的平均间隔时间为4年11个月。最大切牙间距离始终大于35毫米。“正面”分析显示，6例患者的咬合平面相对于水平面呈倾斜状。只有3例患者（均为双侧髁突骨折）表现出下颌运动受限。77%的病例中髁突头部的重塑情况非常好。在额状面上，分别有21%的单侧病例和33%的双侧病例存在髁突持续的内侧倾斜。测量得到的关节突长度差异与之前的髁突骨折相关性最高。根据里氏（1960年）和穆利克（1965年）的方法进行放射学评估以判断面部不对称情况，结果显示有6例患者（20%）的相关角度差异超过5度。
